Articoli Scientifici di Oftalmologia

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Detecting early keratoconus and avoiding iatrogenc ectasia: the score analyzer

LASIK is a wonderful technique that has enabled millions of people to enjoy spectacle independence and improved UCVA over the past 20 years. 

Post-LASIK ectasia is a rare (estimated prevalence, less than 1 in 2,000) but potentially sight-threatening complication. The main risk factor for post-LASIK ectasia is the presence of undetected early forms of subclinical keratoconus.

Therefore, improving the sensitivity and specificity of automated techniques for preoperative screening with corneal topography is a valuable goal in refractive surgery.

Initially, Placido-disc–based detection indices derived from specular anterior corneal topography were judged the most sensitive and specific to detect the earliest forms of subclinical keratoconus.


•   The main risk factor for post-LASIK ectasia is the presence of undetected early forms of subclinical keratoconus; therefore, improving the sensitivity and specificity of automated techniques for preoperative screening with corneal topography is a valuable goal in refractive surgery.

 •  The concept of the SCORE Analyzer originated from the authors’ aim to provide clinicians with a unique number to rate the ectasia susceptibility of myopic eyes by using linear discriminant analysis.

 •  Study results confirmed that the combination of Placido, elevation, and tomography data is a more sensitive and specific detector of early subclinical keratoconus than either Placido-disc topography or elevation data alone. 
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